Provider Demographics
NPI:1174724876
Name:JABER, ROLLA (MD)
Entity type:Individual
Prefix:DR
First Name:ROLLA
Middle Name:
Last Name:JABER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROLLA
Other - Middle Name:NABIH
Other - Last Name:ABDUL-KHALEK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3700 JOSEPH SIEWICK DRIVE
Mailing Address - Street 2:SUITE 403
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22033
Mailing Address - Country:US
Mailing Address - Phone:703-378-2672
Mailing Address - Fax:
Practice Address - Street 1:3700 JOSEPH SIEWICK DR
Practice Address - Street 2:SUITE 403
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22033-1744
Practice Address - Country:US
Practice Address - Phone:703-648-2488
Practice Address - Fax:703-648-2489
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2011-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301082528207N00000X
VA0101242253207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology